Legacy Dental Practice Pllc

NPI #1063678613 in Hilton, New York

Provider Information

NPI Number: 1063678613
Entity Type: Organization
Organization Name: Legacy Dental Practice Pllc
Primary Specialty: Dentist
Enumeration Date: Aug 4, 2008
Last Updated: Aug 4, 2008

Practice Location

Address: 190 FERGUSON DR
City: Hilton
State: New York
ZIP Code: 14468-9504
Phone: (585) 720-1370

Authorized Official

Name: DR. GARY LOUIS GUSMEROTTI, DDS
Title: PRESIDENT
Phone: (585) 720-1370

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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